THE CYPRESS GIVING TREE APPLICATION FOR ASSISTANCE

Please fill out this form as completely as possible and submit NO LATER THAN November 10.  You will then be contacted on November 17 or 18 to schedule a personal interview with Pastor Laurie Hurd.

STEP 1 - Identify who needs assistance

Person(s) in need of assistance

If you are applying for assistance for YOURSELF, please skip to STEP 3

STEP 2 - If you are applying on someone's behalf, please complete the following:

Your Name 

Relationship to person/family in need 

Relationship to / involvement with Cypress

Phone   Email

STEP 3 - Contact information for the person/family in need

Phone     Email

Address

City   State    Zip 

STEP 4 - Describe the need

To the best of your ability, please describe the applicant's current situation which would qualify them for assistance

 

Is the applicant currently receiving aid from other sources, either seasonal help or on a daily basis?  Please explain.

 

STEP 5 - Family information

Please list ALL family members living in the household:

Name   Age   Relationship

Name   Age   Relationship

Name   Age   Relationship

Name   Age   Relationship

Name   Age   Relationship

Name   Age   Relationship

Once the application has been reviewed and considered, you (the one filling out the application) will be contacted by Pastor Laurie Hurd, as mentioned above, to schedule the required personal interview.